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Food for Sight

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Author : Dr Freya Rao

 FOOD FOR HEALTHY EYES

“Doctor what can I feed my child to get rid of their glasses?”, “Arre mera baccha toh ekdum fussy eater. What to do?”. I hear these questions every day. How wonderful it would be to be able to say, here, eat this vegetable or drink this juice and all will be well! Our body needs nutrients the way a building under construction needs materials. We can’t say cement is “yuck!” and bricks are “eww!”, so let's just make the building out of sand and water. Just the same way, our body needs different nutrients to stay healthy. The eyes are no exception.  

In this blog I'm highlighting food that is specifically needed for the eyes. This does not indicate that only these should be eaten, but that the following foods need to be included in the diet for maintaining good eye health. Remember that the rest of the body needs these nutrients too. If they are in short supply, the body will give more importance to the nutritional needs of vital organs, and there won’t be enough left over for the eyes! 

As far as fussy eating habits of children go, the right person to address this is a counselor or psychologist who specialises in children’s mental and emotional needs. (link here for/from child psychologist). A nutritionist would be the best guide to a specific healthy diet tailored to individual needs (Link for/from Nutritionist) 

I would like to make a few suggestions though. The most important one is for us as parents to stop using the TV or mobile or tablet as a babysitter so we can quickly stuff our kids' faces while they are distracted by the screen. Children lose out on developing their own tastes and end up refusing to eat unless a screen is shoved in front of them. They will also miss out on developing certain social skills and graces that come when we eat together. The other suggestion is that we involve our kids in the kitchen. Eating food has become a spectator sport; just like we become cricket experts when watching a match we haven't put any personal effort into, our kids become food critics when someone else has put the effort into planning, preparing and serving a meal. And after all, cooking is a survival skill we should arm our children with (Boys as well as girls!)

The nutrients that are of especial benefit for the eye are as follows:

1. Vitamin A

2. Vitamin C 

3. Vitamin E 

4. Lutein, Zeaxanthin

5. Essential fatty acids (Omega 3, DHA, GLA)

6. Zinc

These are to be consumed as a normal part of a balanced diet, unless a particular deficiency has been diagnosed. In that case a Nutritionist is the right professional to turn to for detailed advice.

1. Vitamin A

India faces Vitamin A deficiency as one of the commonest and most easily prevented causes of blindness, especially in children. However, if you are reading this on a digital device, you are likely blessed enough to not have this extreme as a concern. 

Vitamin A is needed to see light via special cells in our retina called photoreceptors. The most common problem we see in deficiency of Vitamin A is night blindness where the patient finds it hard to see in dim light. It is also essential in maintaining the health of the cells that line our body surfaces (epithelial tissues) including the skin, intestines, mouth and nose lining and yes, the lining of the eyes. Vitamin A Deficiency can cause dryness of the eyes which can cause breakdown of the eye tissues and blindness in the most severe forms. Vitamin A drops have also been tried effectively in certain types of dry eye disease.

The ready form of Vitamin A is available only in animal sources of food like egg yolks and dairy products. Many milk products are Vitamin A fortified as well.

A precursor of Vitamin A called provitamin A or carotenoids is widely found in plant sources, which include lutein and zeaxanthin (which I will come to later). An easy way to remember which ones is to seek out dark shades of green, orange and red. Green leafy vegetables like spinach (palak), fenugreek (methi), drumsticks are something we all know about. But guess what! Coriander (dhania), mint (pudhina), and curry leaf (kadipatta) leaves are each an excellent source of Vitamin A and Iron, too. You need not turn to expensive sources like Kale, the powerhouses can be in your garnish or chaunka! Orange foods like pumpkin, orange and (yay!) mango are great too as are red foods like beetroot. Sweet potato is a good source as well.

2. Vitamin C

Interesting fact...Primates cannot secrete Vitamin C! We humans, as members of the Primates, are dependent on fruit and other sources of Vitamin C to fulfil our requirements. We can’t store this in our bodies; any excess is thrown out right away in our urine. And the body fluid that has the highest concentration of Vitamin C in human s is the aqueous humor, which flows in the front part of the inside of the eyeball. This concentration increases or decreases according to our intake. There are studies that suggest that antioxidants like Vitamin C, when present in good proportion in the eye fluid, can reduce or delay risk of cataract and other eye diseases! On the other hand, low intake of these beneficial nutrients is linked with cataracts forming earlier than normal.

Vitamin C is essential for wound healing as well. A diet rich in fruit also is observed to lead to less tiredness and better immunity. The COVID pandemic has truly brought the importance of this humble nutrient into better focus. Supplements of Vitamin C form a basic part of all preventive as well as therapy regimens for COVID and other viral infections too. In fact, think about it, traditionally we carry fruit as a gift whenever we visit someone who is unwell!

It’s fine to take a supplement, but the lower amounts of Vitamin C in natural food sources compared to a supplement is balanced out by something called higher bioavailability (which means that the body can use it better). The humble Indian gooseberry (Amla) has been classified as a superfood for its superb content of Vitamin C. Citrus fruits like lemon, orange, sweet lime (mosambi )  are great sources, as well as guava, kiwi, mango, papaya, pineapple. Vegetables like broccoli, cauliflower, bell peppers also have Vitamin C, but cooking destroys a large proportion of the content.

Remember that this is a delicate Vitamin that starts to reduce in proportion the minute you cut a fruit, and much more loss occurs on cooking. Raw  fresh fruit is therefore the best natural source of Vitamin C.

3. Vitamin E

This is a fat-soluble antioxidant Vitamin that reduces the ill effects of certain toxic substances called free radicals which damage our cells and cause premature aging effects. Like the brain, the retina of the eye has a high fat content and so this fat soluble Vitamin E plays an important part in maintaining eye health. There are studies that claim delay in cataract formation by regular Vitamin E intake. A lot of sources of Vitamin E also provide essential fatty acids (which I cover subsequently.)

Foods rich in this Vitamin include tree nuts like almonds, oilseeds including sunflower and flaxseed provide Vitamin E.

4. Lutein and Zeaxanthin

These nutrients have received a lot of attention in recent years as a way to prevent age related damage to the retina (Age Related Macular Degeneration or ARMD) which can permanently devastate the central vision and also are believed to delay cataract formation. They are yellow carotenoids similar to Vitamin A that are found in a higher concentration in the most sensitive central part of the retina called the macula. These also have antioxidant properties.

Lutein and Zeaxanthin are nature’s way of protecting our eyes from sun damage from UltraViolet (UV) and blue light rays. The concentration of these nutrients in the eye increases in direct proportion to our intake and healthy tissue in the retina shows a good content of these antioxidants. These are also recommended as part of Vitamin supplements for people with Diabetes.

Other than their similar role in health, these two nutrients are also found in the same foods and therefore tend to be referred to together. They also have a lot of overlap with Vitamin A rich foods since they too are carotenoids (precursor form of Vitamin A found in plants). So again dark green foods, yellow, red and orange coloured foods are great sources...spinach and other dark leafy greens, green peas, pistachios, egg yolk (the best single source), yellow corn, grapes, oranges and so on. 

(link for lutein and zeaxanthin rich recipe)

5. Essential fatty acids (EFAs) 

These are ‘healthy fats’ that the body cannot manufacture on its own and therefore they are essential (thus the name!) for us to consume in our food. We are bombarded with paediatric supplements that talk about Omega-3, DHA and EPA and how cleverly they have been added to their formulas. 

In fact, along with Vitamin A, Vitamin E, Lutein and Zeazanthin, essential fatty acids can be properly obtained and absorbed by the body only in the presence of (a limited quantity of) fat in our food. There are healthy choices to be made in this regard too, like flaxseed oil, olive oil or avocado oil, even desi ghee which contain plenty of Vitamin E too. (link on healthy fats by nutritionist)

Omega-3 fatty acids (especially long-chain omega-3 fatty acids EPA and DHA) are important for eye health and are essential especially in the growing stages for brain function. Since the retina develops from the brain...yes, really it does...the growing retina needs EFAs for proper development of the visual system and retinal function. 

EFAs also play an important part in maintaining the health of our eye surface and preventing dryness. In today’s digital age, more so when COVID is enforcing work/study from home, this is all the more crucial.

Traditionally we doctors rattle off fish liver oil sources or oily/ fatty fish like salmon (rawas) and mackerel (bangda) as great sources, which they are. But where did the fish eat it? They are essential for them too, meaning fish don't manufacture it in their bodies either. It's the marine algae and seaweed that manufacture the EFAs we eventually get through fish. Therefore now you have an option of algae based supplements if you are environmentally conscious or vegetarian/ vegan! (link about environmental impact by deep sea fishing trawlers). 

Unroasted nuts and oilseeds like almond, Walnut, flax seeds, chia seeds, pumpkin seeds, sunflower seeds also give us Omega-6 in addition to Omega-3 EFAs. Primrose oil and starflower oil supplements offer Omega-6 too.

So when mom asks you beta badaam khaya kya, you know where she's coming from!

 6. Zinc

The mineral Zinc is an important player! So often mentioned as an afterthought in multivitamins, maybe because “uska roll number last hai”, Zinc offers us a lot of benefits. It is a part of many enzymes carrying out essential functions, and also seems to boost the potency of other vitamins needed in retinal function, being involved in the formation of the pigments in the retina that allow us to see.

At the same time, its over intake via supplements can cause some harm. It is best consumed in naturally occurring sources of Zinc like in peanuts, pumpkin seeds, cashew nuts (Kaju), sesame seeds (Til), chickpeas (kabuli chana), kidney beans, red meat and some shellfish like oysters, crab and shrimp. Milk products like cheese have zinc depending on what the cows have been eating! Sprouted / fermented beans and dals kick up the zinc absorption too.

But here’s why zinc is my favorite...dark chocolate contains a lot of Zinc! Like we needed more reasons, right.

There are multiple factors that determine the start and severity of vision loss in eye conditions like your age, family history and genetics, other diseases of the body and eyes, stress levels and lifestyle. Whether you have spectacle power, cataracts, macular degeneration, glaucoma, diabetic retinopathy, Age Related Macular Degeneration or any other eye problem please do not be under the impression that a change in diet or overloading on certain foods will treat or cure the condition. Neither is supplementation with Vitamins and minerals in capsule or tablet form required for every person! A balanced and healthy diet containing all these foods in the right proportions will surely help in keeping your eyes healthy. A regular eye exam with the Ophthalmologist at your nearest Eye Solutions at least once a year will also help in reducing the risk of eye problems through early detection and prompt and effective treatment.

Do follow the treatment plan set out by your Ophthalmologist and think of nutrition as supportive to managing your eyes. Your Physician too would set out dietary suggestions for other conditions like diabetes and blood pressure all of which need to take priority over the information in this article.

Wishing you happy eyes and sparkly vision!

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